Central corneal thickness assessment after phacoemulsification: Subluxation versus Divide-and-Conquer

Abstract

To compare the impact of two phacoemulsification techniques (subluxation versus divide-and-conquer) on postoperative corneal edema at postoperative hour 1 and day 4. Comparative study. Ninety-six consecutive patients (110 eyes; 43 men and 53 women, mean age 70.9±9.8years) with equivalent cataract grades underwent cataract surgery and were followed up for 6 months. The presence of corneal edema was determined using central corneal thickness (CCT). CCT was measured preoperatively, and at postoperative hour 1 and day 4. Ultrasound power (US %), duration of ultrasound (TPA), effective ultrasound time (TPE), surgical duration and final suture (%). Eyes of participants were divided into two phacoemulsification technique groups: subluxation (n=50 eyes) and divide-and-conquer (n=60 eyes). Non-inferiority analysis revealed similar CCT increases at postoperative hour 1 in both groups, with 69.9±44.9μm and 64.4±42.9μm, observed in the subluxation and divide-and-conquer groups, respectively (P=0.033). TPE was similar in both groups, taking 6.2±3.4 and 7.3±4.5seconds in the subluxation and divide-and-conquer groups, respectively (P=0.150). No correlation was seen between TPE and edema at postoperative hour 1, or between TPE and day4 edema. Rate of final suture use was similar between the subluxation and divide and conquer groups, at 36% and 30%, respectively. The study findings suggest that cataract surgery performed using the subluxation technique does not result in greater CCT than the divide-and-conquer technique. CCT appears to normalize by postoperative day 4, regardless of the technique used.